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• ~~~ CMT <br />• <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT N0. C-81-025 <br />C.O. N0. <br />N.O.V. N0. C-88-025 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIVIL PENALTY on the operator therein described by _(a}* personal service <br />upon the operator or its representative at , <br />Colorado on , 19 , or XX~ by eposit~ng a true <br />copy thereo first c ass postage prepaid in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on M~v 3]. , <br />1988 . <br />ignature a erson erve <br />if personal service <br />Print Name and it e <br />Certified Mail No. P 765 476 075 <br />Return Recei t R u to <br />i ure <br />sment Officer <br />Print Name and it e <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by C.R.S. 34-33-123(8). <br /> <br />~u~ s ~sas <br />(5/85) <br />S.~cwwM~Sg ~.-oa` ~rri~gtilY <br />Operator <br />8y <br />S//ignature <br />Date C,Juve (o 1988 <br />Doc. No. 251 <br />